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House takes offensive in funding debate

The Mississippi Legislature’s epic battle over Medicaid fundingmay be turning in a new direction, as the seemingly unbreakablesupport in the Senate for a Mississippi Hospital Association-backedassessment plan took a crippling hit last week when 22 Senators -almost half of the chamber – attempted to pass legislation callingfor a cigarette tax.

Even though Lt. Gov. Phil Bryant refused to allow the bill tocome to a vote, saying a tobacco tax increase was not included inthe governor’s special session call and therefore unconstitutional,the failed legislation marks the first time anyone other than HouseDemocrats have attempted to fell support for Senate Bill 2013.

Also biting into the stature of SB 2013 was Friday’s passage ofHouse Bill 17, which would prohibit Gov. Haley Barbour fromcarrying out his often-threatened cuts to Medicaid programs untilJan. 31, 2009. The legislation drew down the governor’s scornFriday, as he released a statement accusing the House of violatingits oath of office for voting to proceed with an unbalancedbudget.

Even though Barbour has already promised to veto HB 17 if itclears the Senate, where the legislation now awaits action, locallegislators say it’s not the bill’s future, but its nature thatmatters.

“We had some crossover votes from Republicans,” said District 91Rep. Bob Evans, D-Monticello. “We had to have a three-fifths voteto get this passed; we had to have 68. And lo and behold, I lookedup and we had 68.”

Evans said the recent emergence of Senate Democrats and thesecond-guessing of some House Republicans signals the lack of unitybehind SB 2013.

“The resoluteness that was there was not what it seemed to be,”he said. “Yes, it passed the Senate on a vote of 41-7, but therewere mitigating circumstances that has caused it to come apart.Just like the hospital association, they agreed to it, but onlyunder duress.”

District 53 Rep. Bobby Moak, D-Bogue Chitto, said thelegislative action undertaken Thursday and Friday might finallyresult in the inclusion of a tobacco tax in any Medicaid fundingsolution. He said SB 2013 is now effectively dead, as the Housestands firmer than ever on its position to keep the bill off thefloor and the Senate’s new rift will prevent the passage of similarlegislation in that chamber.

“The Senate is in a huge bind – they don’t have enough votes topass anything now,” Moak said. “Even if we sent them over a raw bedtax, they couldn’t pass it. There will be pressure for them to acton HB 17.”

Moak said he believes headway will be made on a hybrid bill whenboth chambers reconvene Wednesday, a bill that will includelanguage stating any future increase in tobacco taxes would beadded to a hospital assessment.

No matter what happens Wednesday, Moak said, the hospitalassessment plan – which looked as if it might go the distance onlya week ago – has been considerably weakened. He said the House’sstance against it will be stronger now that dissent in the Senateis evident.

“That bill is going down in flames in the Senate,” he said. “Thegovernor’s dog ain’t winning the fight right now. That’s why he hadto come out and promise to veto HB 17 – the Senate no longer hasthe juice. They’ve switched from playing offense to playingdefense.”

The House is now on offense. It solidified its position byadjourning immediately after the Senate Friday – a move that willnot allow the governor to adjourn the special session, an optionthat would be open if both chambers failed to agree on a time ofrecess.

“We wanted to take that option away from him, because we knowhe’s all hacked off at us for passing HB 17,” Moak said. “Now, wewill be in session when he proposes his Medicaid cuts.”

Not all legislative support for the hospital assessment plan hasfailed, however. District 92 Rep. Becky Currie, R-Brookhaven,remains firm in her support for HB 2013, citing increased Medicaidreimbursements for the hospitals in her district – King’s DaughtersMedical Center and Franklin County Memorial Hospital – as thereason.

The administrators of both facilities have called for SB 2013 tobe passed, though both said the inclusion of an increased tobaccotax would be preferable.

“This bill will fix Medicaid funding for at least five years,and the hospitals will make more money than they did before,” shesaid. “I understand they want a cigarette tax, and we may go backinto session before January to deal with one. But this is along-term fix, and it’s a good bill.”

Currie voted against HB 17, saying it was a waste of time andtaxpayers’ money to produce the bill, as the governor had alreadysaid he would veto the legislation before it was ever brought outonto the House floor.

“There really wasn’t much point in it,” she said. “Anyway, it’sunconstitutional for a legislator to vote and cause a deficit, andI wasn’t going to vote on something unconstitutional.”

Anyway, given the lieutenant governor’s stance on Medicaid,Currie said the Senate would not take up HB 17.

“If the Senate took this bill up, I would laugh all the wayhome,” she said.

Currie said she was surprised to see the handful of HouseRepublicans cross over and support HB 17. She speculated they wereunder pressure from the hospitals in their district that will notcome out ahead under the assessment plan.

Hospitals with lower volumes of Medicaid patients may lose moneyunder the assessment plan. But even that is no cause for concern,Currie said, as plans are in the works for shoring up all hospitalsif HB 2013 is passed.

“For those hospitals that make more money from SB 2013, thehospital association is considering making them pay more formembership,” she revealed. “Then the association will give thatmoney to hospitals that didn’t come out as well.”

Currie said the proposal is not part of SB 2013, but a privateagreement between certain hospitals and the association.